Psychiatry and the geriatric syndromes – creating constructive interfaces

Thacker, Simon; Skelton, Mike; Harwood, Rowan H.

doi:10.1192/pb.bp.115.051649

Cited by 10 publications

(5 citation statements)

References 40 publications

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“…Cognitive dysfunction can develop as a result of different pathological conditions, such as volume reduction of grey and white matter in the brain, and vision and hearing disorders [ 1 ]. The presence of cognitive dysfunction may predispose delirium [ 2 ], depression [ 3 ], and dementia [ 1 , 4 ]. Dementia has been associated with many difficulties for both patients and their families.…”

Section: Introductionmentioning

confidence: 99%

Prognosis of treatment outcomes by cognitive and physical scales

Jakavonytė-Akstinienė

Dikčius

Macijauskienė

2018

Open Medicine

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AbstractThe aim of this study was to assess the possibility of using scales for measuring cognitive and physical functions for a prognosis of care outcomes in elderly patients. Methodology. The survey was carried out in one of the Vilnius City Hospitals for Nursing and Support Treatment. A total number of 177 respondents were involved in the study. The Mini–Mental State Examination (MMSE), The Barthel Index (BI) and The Morse Fall Scale were used. Results. A statistically significant correlation was revealed between the scores of MMSE and BI (Pearson R = 0.41, p < 0.01); those with severe cognitive impairment were more dependent. A statistically significant correlation (Pearson R = −0.181, p < 0.01) was reported between the scores of MMSE and the Morse Fall Scale – the risk of falling was higher in patients with severe cognitive impairment. Conclusions. The Morse Fall Scale was not suitable for the prognosis of outcomes. The MMSE was suitable for the prognosis of a patient’s discharge. The Barthel Index should be considered as the most suitable tool for the prognosis of care outcomes: the sum-score of the Barthel Index above 25 may suggest that the patient would be discharged home; the sum-score below this level was associated with a higher likelihood of patient death.

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Section: Introductionmentioning

confidence: 99%

Prognosis of treatment outcomes by cognitive and physical scales

Jakavonytė-Akstinienė

Dikčius

Macijauskienė

2018

Open Medicine

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“…The development of specialised CLPOA within integrated healthcare systems is more likely to ensure that medically ill older adults get the seamless and responsive help they need. 9 A CLPOA service based in the hospital and integrated with other specialist CLP teams (paediatric/working-age adult) and psychologists working in physical health settings, geriatric medicine and allied health, primary and secondary care services, and community providers and support agencies, 10 would be better positioned to respond faster to referrals and provide more liaison and educational activities to the hospital, than POA in-reach or hybrid POA/generic adult CLP service models.…”

Section: Discussionmentioning

confidence: 99%

A survey of the psychiatric care provided for medically ill older adults in general hospitals in New Zealand

Hopkins,

Skudder,

Sundram

et al. 2023

Australas Psychiatry

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Objective The aim of this study was to conduct an in-depth survey of the psychiatric care provided for medically ill older adults in general hospitals in New Zealand (NZ). Method As part of a larger survey of Consultation-Liaison Psychiatry (CLP) services for all ages in NZ (CLPSNZ-2), a 44-question survey was emailed to clinicians who were involved in providing psychiatric care for medically ill older adults at each of the 16 general hospitals with designated CLP services. Results Responses were obtained from 22 services at 16 hospitals – 14 CLP services and eight Psychiatry of Old Age (POA) in-reach services. These services were found to be under-resourced, operate with highly variable service models, and predominantly provide inpatient consultations. Services could be conceptualised as six prototypes with variations of POA in-reach to hospitals, scope of CLP cover and collaboration between services. Conclusion The heterogeneity in the psychiatric care for medically ill older adults in NZ means that there is an urgent need to develop more consistent CLP service models that better serve the specialist needs of older adults, and establish the policies, resources and standards needed to support them.

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“…The case for specialist, integrated CLP teams for older adults with an explicitly age-appropriate needs-led approach is strong. These teams could sit alongside specialist CLP teams for working age adults, children and adolescents, addictions and the clinical and health psychologists working in physical health settings, all within a broader CLP or psychological medicine umbrella service; and be integrated vertically within the hospital, horizontally with geriatric medicine and allied health and externally with aged residential care, primary and secondary care services and community organisations (Thacker et al, 2017). In support of this, the Royal College of Psychiatrists' Faculty of CLP recommends that one of the two psychiatrists in a CLP service for a 500-bed hospital be an old age psychiatrist (Royal College of Psychiatrists, 2019b).…”

Section: Synthesis and Recommendationsmentioning

confidence: 99%